Ukuchithwa kwendalo

Ukuchithwa kwembumba yindawo yokwakha ulwelo phakathi kweethishu zomgca wemiphunga kunye nesifuba.

Umzimba uvelisa ulwelo oluninzi ngesixa esincinci ukuthambisa umphezulu weplura. Esi sisicwili esibhityileyo esidibanisa isifuba kwaye sijikeleze imiphunga. Ukuchithwa kwe-Pleural kuyinto engaqhelekanga, ingqokelela egqithisileyo yale fluid.

Zimbini iintlobo zokuchithwa kwe-pleural:

• Ukuchithwa kwe-pleudative pleural kubangelwa kukuvuza kwamanzi kwi-pleural space. Oku kusuka kukunyuka koxinzelelo kwimithambo yegazi okanye kubalo olusezantsi lweeproteni. Ukusilela kwentliziyo ngoyena nobangela uqhelekileyo.
• Ukuchithwa kwe-exudative kubangelwa yimithambo yegazi evaliweyo okanye imithambo ye-lymph, ukudumba, usulelo, ukonzakala kwemiphunga kunye nezidumba.

Imiba yomngcipheko we-pleural effusion inokubandakanya:

• Ukutshaya nokusela utywala, kuba ezi zinto zinokubangela isifo sentliziyo, semiphunga kunye nesibindi, ezinokuthi zikhokelele ekuchazeni ukungunda
• Imbali yalo naluphi na unxibelelwano neasbestos

Iimpawu zinokubandakanya nayiphi na kwezi zinto zilandelayo:

• Intlungu yesifuba, ihlala ibuhlungu kakhulu xa ukhohlela okanye uphefumla nzulu
• Khohlela
• Umkhuhlane kunye nokubanda
• Iingqungquthela
• Ukuphefumla ngokukhawuleza
• Ukuqhawukelwa ngumphefumlo

Ngamanye amaxesha akukho zimpawu.

Umboneleli wakho wezempilo uya kukuvavanya kwaye akubuze malunga neempawu zakho. Umboneleli uya kuphulaphula imiphunga yakho nge-stethoscope kwaye ucofe (ukubetha) isifuba sakho kunye nomqolo ongasentla.

Iskena se-CT esifubeni okanye i-x-ray yesifuba inokwanela ukuba umboneleli wakho athathe isigqibo ngonyango.

Umboneleli wakho unokufuna ukwenza uvavanyo kulwelo. Ukuba kunjalo, isampulu yolwelo iyasuswa ngenaliti efakwe phakathi kweembambo. Uvavanyo kulwelo luya kwenziwa ukukhangela:

• Usulelo
• Iiseli zomhlaza
• Amanqanaba eprotheni
• Ukubalwa kweseli
• Ubumanzi bolwelo (ngamanye amaxesha)

Uvavanyo lwegazi olunokwenziwa lunokubandakanya:

• Gcwalisa ubalo lwegazi (CBC), ukujonga iimpawu zosulelo okanye i-anemia
• Uvavanyo lwegazi lwezintso kunye nesibindi

Ukuba kukho imfuneko, olu vavanyo lunokwenziwa:

• I-Ultrasound yentliziyo (i-echocardiogram) ukujonga ukusilela kwentliziyo
• I-Ultrasound yesisu kunye nesibindi
• Ukuvavanywa kweprotein yomchamo
• I-Lung biopsy ukukhangela umhlaza
• Ukugqithisa ityhubhu ngombhobho womoya ukujonga iindlela zomoya kwiingxaki okanye umhlaza (i-bronchoscopy)

Injongo yonyango kukuba:

• Susa umbane
• Thintela ulwelo ekwakhiweni kwakhona
• Chonga kwaye uphathe unobangela wolwakhiwo lolwelo

Ukususa umbane (thoracentesis) kunokwenziwa ukuba kukho ulwelo oluninzi kwaye kubangela uxinzelelo lwesifuba, ukuphefumla okufutshane, okanye inqanaba leoksijini eliphantsi. Ukususa ulwelo kuvumela imiphunga ukuba ikhule, yenze kube lula ukuphefumla.

Unobangela wokwakhiwa kolwelo kufuneka anyangwe:

• Ukuba kungenxa yokusilela kwentliziyo, unokufumana i-diuretics (iipilisi zamanzi) kunye namanye amayeza ukunyanga ukusilela kwentliziyo.
• Ukuba kungenxa yosulelo, ziya kunikwa ii-antibiotics.
• Ukuba sivela kumhlaza, isifo sesibindi, okanye isifo sezintso, unyango kufuneka lujolise kwezi meko.
  

Kubantu abanomhlaza okanye usulelo, i-effusion ihlala inyangwa kusetyenziswa ityhubhu yesifuba ukukhupha ulwelo kunye nokunyanga unobangela.

Ngamanye amaxesha, naluphi na unyango olulandelayo luyenziwa:

• Unyango ngamayeza
• Ukubeka iyeza esifubeni elithintela ukuba ulwakhiwo lungakhi kwakhona emva kokuba litsaliwe
• Unyango ngemitha
• Ugqirha

Isiphumo sixhomekeke kwisifo esisisiseko.

Iingxaki ze-pleural effusion zingabandakanya:

• Umonakalo wemiphunga
• Usulelo olujika lube lithumba, olubizwa ngokuba yimpyema
• Umoya kwisifuba sesifuba (i-pneumothorax) emva kokuhambisa amanzi
• Ukuqina kwe-Pleural (ukunqunyulwa kwebala lomphunga)

Fowunela umnikezeli wakho okanye uye kwigumbi likaxakeka ukuba unayo:

• Iimpawu zokusasazeka kwembambano
• Ukuphefumla kancinci okanye ukuphefumla nzima emva nje kwe-thoracentesis

Ulwelo esifubeni; Ulwelo kumphunga; Ulwelo lwamanzi

• Amaphaphu
• Inkqubo yokuphefumla
• Kwisisu Pleural

Ibhlokhi BK. Thoracentesis. Ku: Roberts JR, Custalow CB, Thomsen TW, ii-eds. Iinkqubo zeKlinikhi zikaRoberts kunye neHedges kwiNyango kaXakeka kunye noKhathalelo oluQhelekileyo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2019: isahluko 9.

I-Broaddus VC, ukuKhanya kweRW. Ukuchithwa kwendalo. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray kunye neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; Ngo-2016: isahluko 79.

UMcCool FD. Izifo zediaphragm, udonga lwesifuba, i-pleura kunye ne-mediastinum. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 92.